Doctor Name: | MR. GEORGE MANDLE |
NPI Number: | 1518138114 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CFY-SLP |
License Number: | TL-1530 |
Business Practice Address: | 249 High St Newton, NJ - 078609600 |
Business Phone Number: | 9735794242 |
Business Fax Number: | 9733838372 |
Mailing Address: | 249 High St, NEWTON |
State: | NJ |
Postal Code: | 078609600 |
Phone Number: | 9735794242 |
Fax Number: | 9733838372 |
NPI Enumeration Date: | 03/21/2008 |
NPI Last Update Date: | 03/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | TL-1530 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |